Arkansas Blue Cross and Blue Shield
Finance / FinServ
Payment&RefundControlSpecialist
“Payment & Refund Control Specialist at Arkansas Blue Cross and Blue Shield. Skills: Payment & Refund Control, Claims Processing, Account Receivable, Financial Data Validation, Problem Resolution. Daily validation of multiple claims payment cycles. Accurate, efficient and timely end-to-end processing of claims refunds and stop payment requests”
Industry & Context.
Problem Solving; Analyze Information; Evaluating Information
Ensure the security and confidentiality of records and information, Adhere to segregation of duties guidelines
What They're Looking For.
Must Have
High School diploma or equivalent, Minimum one (1) year recent bookkeeping or account receivable experience, Microsoft Excel experience required, Proficiency using computer applications, which includes spreadsheets, word processing, and database applications
Nice to Have
Claims processing or claims adjustment experience preferred
What You'll Do.
Daily validation of multiple claims payment cycles
efficient and timely end-to-end processing of claims refunds and stop payment requests
Timely balancing and verifying payment data
Evaluating the results of claim adjustment transaction on payments
Assisting with problem resolution with the appropriate information systems staff
Communication of same to various operational areas
Coordinating the overpayment correspondence function
Creation and delivery of Check Control memos
Initiating systematic releases of payment materials to print and mail operations
Performing daily validation of multiple claims payment cycles
Processing claims refunds and stop payment requests in accordance to corporate policies
and operational procedures and standards
Controlling and disposing returned checks by providers or members and undeliverable checks timely
How You'll Work.
Team & Collaboration
Assisting with problem resolution with the appropriate information systems staff; Communication of same to various operational areas; Works closely with Claims and Customer Service Operations, providers, and occasionally members to resolve problems and respond to inquiries regarding payments and refunds
Communication Scope
Oral & Written Communication; Interpersonal Communication; Oral Communications; Written Communication
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